Medicaid Demonstration Waivers: Recent HHS Approvals Continue to Raise Cost & Oversight Concerns

January 2008 The Government Accountability Office (GAO) review addressed the budget neutrality and fiscal integrity of recently approved, comprehensive section 1115 demonstrations. GAO selected demonstrations to include in this review based on when they were approved and whether they were comprehensive and accounted for a major portion of the states Medicaid program. GAO reviewed demonstrations in Florida and Vermont. GAO found that both were not budget-neutral and that budget assumptions were not well documented . . .